Asthma during pregnancy: an immunologic perspective

ABSTRACT

Asthma is one of the most common medical conditions to complicate pregnancy and represents a significant public health issue. Increased maternal complications and adverse fetal outcomes are associated with asthma during pregnancy. Since asthma can adversely affect the outcome of pregnancy, it is important for us to understand the mechanisms underlying asthma during pregnancy. In general, asthma is characterized by an up-regulated systemic production of T-helper 2 [Th2] cytokines. Pregnancy also brings about changes in maternal immune status making it polarized towards the Th2 phenotype. Based on these considerations, we hypothesize that pregnancy-induced immune alterations may modify allergic mechanisms of asthma and that systemic Th2 cytokine and chemokine polarization does occur among asthmatics to a greater extent during pregnancy. We suggest that this is associated with exacerbation of asthma during pregnancy. The pathophysiology of asthma during pregnancy and the interrelationship between these two conditions are reviewed here